Conserving the Fighting Strength: Sex Modifying Medications and Psychiatric Standards of Fitness in the U.S. Military

Combat Stress Magazine: Fall 2023
Volume 11, Number 3


Or Read the Articles Below

Editor’s Message
Kathy Platoni, PsyD, DAAPM, FAIS

To Conserve the Fighting Strength. Sex Modifying Medications and Psychiatric Standards of Fitness in the U.S. Military: A Repeat of McNamara’s 100,000
By MAJ (RET) C. Alan Hopewell, PhD, MP, ABPP, BSM and CPT Robert Klein, PhD, US Army

From January 26, 2021, onwards, there have been no restrictions on military service by gender dysphoric individuals, and this cohort has now been increasingly and actively recruited by the Armed Forces. However, contrary to the requirement in Directive-Type Memo 16-005 (DTM 16-005) that 2. … “Transgender (sic) Soldiers will be subject to the same standards as any other Soldier of the same gender, (sic)” but this has not proven to be the case. Many, if not most of these Soldiers, are currently exempted from basic military requirements such as physical fitness standards and deployment requirements as a result of a number of issues pertaining to their medical status. This seminal article reviews medication as well as psychological issues among this cohort which may well impact their ability to serve effectively and does so from the experience of actual combat Veterans who have direct experience with these issues who have served in garrison, in combat deployments, and on sexual surgery teams. Parallels are drawn with the failed “Project 100,000” program during the Vietnam War which sacrificed sound scientific knowledge bases for ideological purposes, with the end result neither helping those who were the recipients of the project nor the Armed Forces and eventually resulting in harm to both.

Coming Home Alone
By Dr. Robert R. Rail
The steps we take and the path we walk back home are not the same as the path and steps that we have endured in the war zone conflicts that have forever touched or scared our minds and bodies. Once “there” we can never truly be completely home again. When we walk through the door of understanding and healing like we did as being deployed on a mission, some walk with us, some take our hand, and some we just grab by the shirt and pull along with us. But the door is always open and so is hope for one and all in a future of understanding and healing.

A Different Type of Mission Creep
By Janet L. Rail
Memories can be good and give us great comfort, but there are also times when they can “sneak up” on us in our dreams. Memories of the past creep back into our lives as if it all just happened yesterday.

Boom Fall Down: Dark Humor as Stress Relief
By Officer Tom McMurtry
Have you ever been embarrassed by finding yourself laughing at a joke that should not have been funny. I have. As a retired soldier and a police officer I have spent decades around men and women who do unfunny work under unfunny circumstances. They/we have found ways to poke fun at unfunny things in a way that often makes others cringe and question our mental health. This article is about dark humor, which like spicy food, is an acquired taste and needs to be consumed carefully.

Veterans Treatment Court – A New Way to Address Veterans Involved in the Criminal Justice System Currently at the State Level – And Why it is Needed at the Federal Level
By Colonel DJ Reyes, US Army (RET))
The “cost of war” over two decades of US combat has indeed been costly in terms of our military’s mental health posture. Although most servicemembers have proven their resiliency and successful reintegration back with families and local communities after deployments or transitioning from the military, a disturbing percentage of those who
struggle with service or combat connected conditions resort to bad behavior that often spirals down to illicit or criminal behavior. The Veterans Treatment Court (VTC) which is found in most US states is the “Court of last resort” that helps these criminal justice involved Veterans get back on track. An initiative advocated by retired US Army Colonel DJ Reyes and others are also pursuing the VTC expansion to the US Federal District Court level.

Summary of the Veterans Consortium
By Colleen E. Miller, Esq.
Colleen E. Miller serves as Deputy Director of Volunteer Outreach, Education, and Placement for The Veterans Consortium Pro Bono Program’s CAVC Practice. The Veteran’s Consortium is a leading non-profit organization that provides pro bono legal representation in federal venues to Veterans, their families, caregivers, and survivors. Since 1992, The Veterans Consortium has helped more than 75,400 individuals, handled over 7,702 cases, and trained more than 6,402 pro bono attorneys and associated professionals for its TVC National Volunteer Corps. To learn more about The Veterans Consortium and Ms. Miller’s work.

Closing the Chapter: Stepping Away from Policing and Into a New Mission
By SGT (RET) Caleb Payne
Too few are willing to chronicle the extraordinary difficulties in having no choice but to make the decision to leave the noble law enforcement profession. This is fraught with anguish on every level. What I have learned is that it is absolutely okay to be okay with this and to allow myself to work through the grief process in order to get to the other



Editor In Chief

Daniel L. Kirsch, PhD, DAAPM, FAIS
AIS President


Kathy Platoni, PsyD, DAAPM, FAIS
COL (RET), US Army

Contributing Editors

Josh Briley, PhD, FAIS
Reverend Charles Grantham, PhD, MSH, FAIS, APF
Jeff Jernigan, PhD, LPC, BCCPC, FAIS
Tom McMurtry, DAIS
John H. Thurman, Jr. M.Div., MA
Richard Young, PhD, FAIS

Managing Editor

Kathy Schoop

Creative Director

Michael McMahon

AIS Combat Stress Board

Chaired by Colonel Platoni, the role of this board is to develop initiatives and communications to serve the stress management needs of Service Members and Veterans.

Chair: Kathy Platoni, PsyD, DAAPM, FAIS
COL (RET), US Army, COL/Ohio Military Reserve/State Defense Forces,
Dayton SWAT, Editor, Combat Stress magazine

Richard S. Biehl, MA, FAIS, Police Chief (Ret), Dayton, Ohio

Brian S. Earthman MD, FAIS, Psychiatrist, MAJ (Ret), US Army Reserves, Medical Director, EPI, Inc.

Charlie Bass, MD, PhD, FAIS, LTC (Ret), U.S. Army, Veteran of OIF/OEF

Daniel L. Kirsch, PhD, DAAPM, FAIS, Pain and Stress Specialist, US Navy Contractor (Ret), President, The American Institute of Stress

Combat Stress Magazine

The mission of the nonprofit American Institute of Stress is to improve the health of our community and the world by setting the standard of excellence of stress management in education, research, clinical care and the workplace. Diverse and inclusive, AIS educates healthcare practitioners, scientists, and the public. AIS is the only Institute in America solely dedicated to providing information, training and techniques to prevent and reverse human disorders related to stress, and to improve the quality of life and increase longevity through building resilience to stress. Credentialed AIS members provide leadership to the world on stress related topics.

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